Biography:Claire Karekezi

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Claire Karekezi
Karekezi in 2022
Born (1982-07-04) 4 July 1982 (age 44)
Butare, Rwanda
EducationUniversity of Rwanda (MD), Université Mohammed V (Neurosurgery), University of Toronto (Neuro-oncology and Skull-Base Surgery)
OccupationNeurosurgeon

Claire Karekezi (born 4 July 1982) is a Rwandan neurosurgeon at the Rwanda Military Referral and Teaching Hospital in Kigali, Rwanda.[1] As the first female neurosurgeon in Rwanda, and one of the eight Rwandan neurosurgeons serving a population of 14 million, Karekezi serves as an advocate for women in neurosurgery.[2] She has become an inspiration for young people pursuing neurosurgery, particularly young women.[3][4]

Specializing in Neuro-oncology and Skull-Base Surgery, Karekezi served as the chairperson of the African Women in Neurosurgery (AWIN), Committee of the Continental Association of African Neurosurgical Societies (CAANS) from 2019 to 2023, and was elected as a member of the national council of the Rwanda Medical and Dental Council (RMDC) and the Secretary of the Bureau for 2022–2026.[5]

Early life

Karekezi was born in Butare, Rwanda. Mr.  Karekezi Sr., her father, was a telecommunication engineer, and Mrs. Musine, her mother, was a high school teacher.[6] Karekezi grew up in Kigali, the capital city of Rwanda, where she and her two older siblings received their early education.[4] She enjoyed science as a child, and after sixth grade in elementary school, she majored in mathematics and physics in high school. She met the admission criteria for medical school and studied general medicine in Butare at the University of Rwanda College of Medicine and Health Sciences, graduating as an MD in March 2009. During her time in Butare, Karekezi had her first exposure to neurosurgery, an experience that changed the course of her life.[7][8]

Education

In 2011, she was accepted into the World Federation of Neurosurgical Societies (WFNS) Reference center in Rabat for training African neurosurgeons.[8][7][9][10] This training center was established in 2002 through a partnership between the WFNS and the Faculty of Medicine and Pharmacy of Rabat at Mohammed V University in Rabat, Morocco. Karekezi completed her residency in neurosurgery in May 2016.

After completing her residency in Morocco Karekezi pursued additional training with a focus on Neuro-oncology. In 2016, she spent three months at the Brigham and Women's Hospital in Boston, Massachusetts, as a recipient of the American Association of Neurological Surgeons (AANS) International Visiting Surgeon Fellowship.[10] From 2017 to 2018, she completed a one-year clinical fellowship in neuro oncology and Skull-Base Surgery[11] at Toronto Western Hospital, major research and teaching hospital affiliated to the University of Toronto.

After completing her fellowship in Toronto in August 2018, Karekezi returned to Rwanda as the country's first female neurosurgeon.[3] In her December 2018 TEDxEuston talk,[12] Karekezi painted a clearer picture of the general lack of access to surgery in Africa and the role she plays in training more future neurosurgeons to address this deficit. Karekezi stated, "I refuse to allow being African and a woman to be a limitation for me." She has raised awareness about the significance of neurosurgical education on the African continent, the need for more female neurosurgeons to combat stereotypes, and the severe shortage of neurosurgeons in the continent.[8][13][14]

Professional career and mission

Karekezi joined the Rwanda Military Referral and Teaching Hospital (RMRTH) in January 2019 as the hospital's first consultant neurosurgeon and the first neurosurgeon to perform neurosurgical procedures there. The establishment of a neurosurgery practice in the Rwandan public health sector has not been devoid of obstacles. Upon establishing her practice at RMRTH, she devoted the first few months of her tenure to establishing a functional neurosurgical unit by acquiring the necessary surgical equipment and personnel.[15]

Neurosurgery continues to be a male-dominated field, particularly in Africa, where women neurosurgeons account for less than 12% of all neurosurgeons. Karekezi is determined to enhance mentorship and support for her female colleagues and future generations. In 2019, she was elected as the chair of the African Women in Neurosurgery (AWIN) section of the Continental Association of African Neurosurgical Societies (CAANS).

Karekezi has led numerous projects on the history of women in neurosurgery and their current status on the African continent, highlighting the underrepresentation of women in leadership positions and academic neurosurgery, efforts to improve Neurosurgery Education and brain tumor treatment advances particularly in Sub-Saharan Africa.[16] She continues to raise awareness about the need for more experienced female neurosurgeons in order to assist other young women in overcoming various obstacles inherent to the field.[17] She is also an advocate and inspiration for other young women who wish to pursue STEM fields (science, engineering, technology, and mathematics).[18][19]

Awards

  • Association of Neurological Surgeons (AANS)/Congress of Neurological Surgeons (CNS) Women In Neurosurgery (WINS) Greg Wilkins-Barrick Chair Visiting International Surgeon Award (2013).[20]
  • American Association of Neurological Surgeons (AANS) International Visiting Surgeon Fellowship Award in Neurosurgery/neuro oncology, Brigham and Women's Hospital, Harvard Medical School, USA (2016).[10]
  • Shield Maiden Women in Surgery Africa (WISA) Award in recognition of the arête in achieving career excellence in surgery, COSECSA, Kigali (2018).
  • AIMS-Next Einstein Initiative TTP Women in science 'First Award 2019' for being Rwanda's First Female Neurosurgeon (2019).[21]
  • Forbes Woman Africa Academic Excellence Award (2022).[22]
  • 2023 Leadership Award, Northwestern Medicine, Department of Neurological Surgery, July, 21st, 2023, Chicago, USA
  • Trailblazer in her Surgical Specialty (Neurosurgery), Women In Surgery Rwanda (WiSR), June 2024. Kigali, Rwanda
  • 2024 Mission:BRAIN Uihlein Visiting Scholar Award, Women in Global Neuroscience (WINGS) Symposium, Mission:BRAIN Foundation, October 2024, Houston, USA[23]

Memberships

Dr. Karekezi is an active member of multiple local and international neurosurgical societies in order to raise awareness of neurosurgical needs in low- and middle-income countries, inspire young women, and be in a position to make change. These societies include, The American Association of Neurological surgeons (AANS), The AANS/CNS section on tumors,[24] World Federation of Neurosurgical Societies-Women In Neurosurgery (WFNS-WIN) Committee,[25] Women in Neurosurgery (WINS/USA), African Women in Neurosurgery (AWIN), The College of Surgeons of East, Central and Southern Africa (COSECSA), The Society for Neuro-Oncology (SNO), Women in Surgery AFRICA (WiSA), The Society for Neuro-Oncology/SSA (SNOSSA), Rwanda Surgical Society (RSS), and Rwanda Association of Neurological Surgeons (RANS).

Selected publications

1. Nepogodiev D, Picciochi M, Ademuyiwa A, Adisa A, Agbeko AE, Aguilera ML, Agyei F, Alexander P, Henry J, Anyomih TTK, Aregawi AB, Atun R, Biccard B, Chalwe M, Chu K, Coomarasamy A, Crawford R, Darzi A, Davies J, Gathuya Z, George C, Ghaffar A, Ghosh D, Glasbey JC, Haque PD, Harrison EM, Hesse A, Allen Ingabire JC, Kamarajah SK, Karekezi C, Kruger D, Lapitan MC, Latif A, Lawani I, Ledda V, Li E, Linder C, Makasa E, Martin J, Maswime S, Mathai S, Meara JG, Mudede-Moffat F, Ntirenganya F, Park KB, Phelan LN, Pramesh CS, Ramos-De la Medina A, Raykar N, Rivello R, Roslani AC, Roy N, Samad L, Shrime M, Sobhy S, Sullivan R, Tabiri S, Tangi V, Tissingh E, Weiser TG, Williams O, Bhangu A. Surgical health policy 2025-35: strengthening essential services for tomorrow's needs. Lancet. 2025 Jul 14:S0140-6736(25)00985-7. doi: 10.1016/S0140-6736(25)00985-7. Epub ahead of print. PMID 40675172.[26]

2. Karekezi C. Global neurosurgery partnership: need for more adequate collaborations between high-income countries and low-income countries. Acta Neurochir (Wien). 2024 Apr 12;166(1):176. doi: 10.1007/s00701-024-06061-7.[27]

3. Nyalundja AD, Kanmounye US, Karekezi C, Laeke T, Thango N, Balogun JA. Pediatric brain tumors in sub-Saharan Africa: a systematic review and meta-analysis. J Neurosurg Pediatr. 2024 Mar 15;:1-12.[28]

4. Nyalundja AD, Mugisha F, Karekezi C. The Natural History and Treatment of Meningiomas: An Update. Semin Neurol. 2024 Feb;44(1):1-15.[29]

5. Almeida JP, Marigil-Sanchez M, Karekezi C, Witterick I, Gentili F. Different Approaches in Skull Base Surgery Carry Risks for Different Types of Complications. Acta Neurochir Suppl. 2023;130:13-18.[30]

6. Barthélemy EJ, Diouf SA, Silva ACV, Abu-Bonsrah N, de Souza IAS, Kanmounye US, Gabriel P, Sarpong K, Nduom EK, Lartigue JW, Esene I, Karekezi C. Historical determinants of neurosurgical inequities in Africa and the African diaspora: A review and analysis of coloniality. PLOS Glob Public Health. 2023;3(2):e0001550. doi:10.1371/journal.pgph.0001550. eCollection 2023. Review.[31]

7. Kanmounye US, Karekezi C, Nyalundja AD, Awad AK, Laeke T, Balogun JA. Adult brain tumors in Sub-Saharan Africa: A scoping review. Neuro Oncol. 2022 Oct 3;24(10):1799-1806. doi: 10.1093/neuonc/noac098. Review.[32]

8. Dada OE, Karekezi C, Mbangtang CB, Chellunga ES, Mbaye T, Konan L, Adeniran Bankole ND, Merci Kabulo KD, Hugues Dokponou YC, Ghomsi NC, Negida A, Nguembu S, Thango N, Cheserem B, Kamabu LK, Alalade AF, Esene I, Kanmounye US. State of Neurosurgical Education in Africa: A Narrative Review. World Neurosurg. 2021 Jul;151:172-181.[33]

9. Karekezi C, Thango N, Aliu-Ibrahim SA, Bechri H, You Broalet EM, Bougrine M, Cheserem JB, Mbaye M, Shabhay ZA, Tighilt N, Bakhti S, El Abbadi N. History of African women in neurosurgery. Neurosurg Focus. 2021 Mar;50(3).[34]

10. Karekezi C, El Khamlichi A, El Ouahabi A, El Abbadi N, Ahokpossi SA, Ahanogbe KMH, Berete I, Bouya SM, Coulibaly O, Dao I, Djoubairou BO, Doleagbenou AAK, Egu KP, Ekouele Mbaki HB, Kinata-Bambino SB, Habibou LM, Mousse AN, Ngamasata T, Ntalaja J, Onen J, Quenum K, Seylan D, Sogoba Y, Servadei F, Germano IM. The impact of African-trained neurosurgeons on sub-Saharan Africa. Neurosurg Focus. 2020 Mar 1;48(3):E4.[35]

11. Marigil Sanchez M, Karekezi C, Almeida JP, Kalyvas A, Castro V, Velasquez C, Gentili F. Management of Giant Pituitary Adenomas: Role and Outcome of the Endoscopic Endonasal Surgical Approach. Neurosurg Clin N Am. 2019 Oct;30(4):433-444.[36]

12. Karekezi C, El Khamlichi A. Takeoff of African Neurosurgery and the World Federation of Neurosurgical Societies Rabat Training Center Alumni. World Neurosurg. 2019 Jun; 126:576-580. doi: 10.1016/j.wneu.2019.03.141. Epub 2019 Mar 22.[37]

References

  1. ↑ "HOME". https://rwandamilitaryhospital.rw/index.php?id=23. 
  2. ↑ "Claire Karekezi Profile - Practicing Neurosurgery in Sub-Saharan Africa - Congress of Neurological Surgeons (CNS)". https://www.cns.org/publications/congress-quarterly/congress-quarterly-detail/claire-karekezi-profile-practicing-neurosurgery-in. 
  3. ↑ 3.0 3.1 "She's Rwanda's first and only female neurosurgeon. She chose Toronto to complete her training" (in en-CA). The Toronto Star. 2018-05-13. ISSN 0319-0781. https://www.thestar.com/news/gta/2018/05/13/shes-rwandas-first-and-only-female-neurosurgeon-she-chose-toronto-to-complete-her-training.html. 
  4. ↑ 4.0 4.1 Chu, Kathryn (2022-03-05). "Inspirational Women in Surgery: Dr Claire Karekezi, Neurosurgeon, Rwanda" (in en). World Journal of Surgery 46 (9): 2061–2062. doi:10.1007/s00268-022-06490-4. ISSN 1432-2323. PMID 35246713. 
  5. ↑ "The Bureau". https://rmdc.rw/spip.php?article4. 
  6. ↑ "Meet Dr. Claire Karekezi, Rwanda's First Female Neurosurgeon" (in en-US). 2024-03-08. https://kigalijournal.com/meet-dr-claire-karekezi-rwandas-first-female-neurosurgeon/. 
  7. ↑ 7.0 7.1 Karekezi, Claire; El Khamlichi, Abdeslam (July 2019). "Takeoff of African Neurosurgery and the World Federation of Neurosurgical Societies Rabat Training Center Alumni". World Neurosurgery 126: 576–580. doi:10.1016/j.wneu.2019.03.141. ISSN 1878-8750. PMID 30910756. 
  8. ↑ 8.0 8.1 8.2 Karekezi, Claire; Khamlichi, Abdeslam El; Ouahabi, Abdessamad El; Abbadi, Najia El; Ahokpossi, Semevo Alidegnon; Ahanogbe, Kodjo Mensah Hobli; Berete, Ibrahima; Bouya, Soueilem Mohamed et al. (2020-03-01). "The impact of African-trained neurosurgeons on sub-Saharan Africa" (in en-US). Neurosurgical Focus 48 (3): E4. doi:10.3171/2019.12.FOCUS19853. ISSN 1092-0684. PMID 32114560. https://thejns.org/focus/view/journals/neurosurg-focus/48/3/article-pE4.xml. 
  9. ↑ "Rabat Reference Center for Training Young African Neurosurgeons | World Federation of Neurosurgical Societies". https://www.wfns.org/training-centers/5/. 
  10. ↑ 10.0 10.1 10.2 "American Association of Neurological Surgeons" (in en). https://www.aans.org/. 
  11. ↑ "Fellowship in Neurooncology" (in en). https://surgery.utoronto.ca/fellowship-neurooncology. 
  12. ↑ "Joining the ranks of Neurosurgery: My Impossible Dream". 19 December 2018. https://www.ted.com/talks/claire_karekezi_joining_the_ranks_of_neurosurgery_my_impossible_dream. 
  13. ↑ (in en) AIMS Teacher Training Program, TTP Rwanda - Claire Karekezi, The first Rwandan female neurosurgeon | Facebook, https://www.facebook.com/AIMS-Teacher-Training-Program-TTP-Rwanda-102248341148499/videos/claire-karekezi-the-first-rwandan-female-neurosurgeon/3995487413797395/, retrieved 2022-05-18 
  14. ↑ Dada, Olaoluwa Ezekiel; Karekezi, Claire; Mbangtang, Celestin Bilong; Chellunga, Edwin Samwel; Mbaye, Thioub; Konan, Landry; Adeniran Bankole, Nourou Dine; Merci Kabulo, Katenga Dieu et al. (July 2021). "State of Neurosurgical Education in Africa: A Narrative Review" (in en). World Neurosurgery 151: 172–181. doi:10.1016/j.wneu.2021.05.086. PMID 34058355. https://linkinghub.elsevier.com/retrieve/pii/S1878875021007816. 
  15. ↑ "Claire Karekezi:Practicing Neurosurgery in Sub-Saharan Africa". 20 January 2020. https://www.cns.org/publications/cns-spotlight-archives/claire-karekezi-profile-practicing-neurosurgery-in. 
  16. ↑ Karekezi, Claire; Thango, Nqobile; Aliu-Ibrahim, Salamat Ahuoiza; Bechri, Hajar; You Broalet, Espérance Maman; Bougrine, Mouna; Cheserem, Jebet Beverly; Mbaye, Maguette et al. (March 2021). "History of African women in neurosurgery". Neurosurgical Focus 50 (3): E15. doi:10.3171/2020.12.FOCUS20905. ISSN 1092-0684. PMID 33789234. https://thejns.org/view/journals/neurosurg-focus/50/3/article-pE15.xml. 
  17. ↑ Sadler, Samantha J.; Yuki Ip, Ho Kei; Kim, Eliana; Karekezi, Claire; Robertson, Faith C. (March 2021). "Investing in the future: a call for strategies to empower and expand representation of women in neurosurgery worldwide". Neurosurgical Focus 50 (3): E8. doi:10.3171/2020.12.FOCUS20963. ISSN 1092-0684. PMID 33789242. https://thejns.org/view/journals/neurosurg-focus/50/3/article-pE8.xml. 
  18. ↑ Keshmiri, Firouzeh; Bloor, Ann; Wellenstein, Mary Jo (2006). "Wisconsin And Hawaii Wit Partnership To Encourage Women And Girls In Rural Areas To Pursue Stem Fields". 2006 Annual Conference & Exposition Proceedings (ASEE Conferences): 11.1453.1–11.1453.8. doi:10.18260/1-2--938. 
  19. ↑ (in sw) UNICEF Rwanda - Women in STEM: Claire Karekezi | Facebook, https://sw-ke.facebook.com/unicefrw/videos/women-in-stem-claire-karekezi/920298841793179/, retrieved 2022-05-18 
  20. ↑ "AANS Neurosurgeon – International Initiatives: Launching the WINS/Greg Wilkins-Barrick Chair Visiting International Surgeon Award". http://v1archives.aansneurosurgeon.org/8/women-in-neurosurgery-international-initiatives/. 
  21. ↑ "Women scientists encourage Rwandan girls to continue in STEM related fields – African Institute for Mathematical Sciences". https://nexteinstein.org/ttp-rwanda-celebrates-international-day-of-women-and-girls-in-science/. 
  22. ↑ "Forbes Woman Africa. The @Forbeswomanafri Academic Excellence Award goes to Dr. @clairekarekezi, Chair of the African Women in Neurosurgery (AWIN). Congratulations Dr. Karekezi!" (in en). https://twitter.com/forbeswomanafri/status/1501922447083421697. 
  23. ↑ "Scholarships". https://www.missionbrain.org/scholarships-folder/scholarships. 
  24. ↑ "Leadership and Committees – Tumor Section". https://tumorsection.org/leadership-and-committees/. 
  25. ↑ "Committees | World Federation of Neurosurgical Societies". https://wfns.org/committees. 
  26. ↑ Nepogodiev, Dmitri; Picciochi, Maria; Ademuyiwa, Adesoji; Adisa, Adewale; Agbeko, Anita E; Aguilera, Maria-Lorena; Agyei, Fareeda; Alexander, Philip et al. (July 2025). "Surgical health policy 2025–35: strengthening essential services for tomorrow's needs" (in en). The Lancet. doi:10.1016/S0140-6736(25)00985-7. PMID 40675172. https://linkinghub.elsevier.com/retrieve/pii/S0140673625009857. 
  27. ↑ Karekezi, Claire (2024-04-12). "Global neurosurgery partnership: need for more adequate collaborations between high-income countries and low-income countries" (in en). Acta Neurochirurgica 166 (1). doi:10.1007/s00701-024-06061-7. ISSN 0942-0940. PMID 38607404. 
  28. ↑ Nyalundja, Arsene Daniel; Kanmounye, Ulrick Sidney; Karekezi, Claire; Laeke, Tsegazeab; Thango, Nqobile; Balogun, James A. (2024-06-01). "Pediatric brain tumors in sub-Saharan Africa: a systematic review and meta-analysis". Journal of Neurosurgery: Pediatrics 33 (6): 524–535. doi:10.3171/2024.1.PEDS23282. ISSN 1933-0707. PMID 38489811. https://thejns.org/view/journals/j-neurosurg-pediatr/33/6/article-p524.xml. 
  29. ↑ Nyalundja, Arsene Daniel; Mugisha, Fabrice; Karekezi, Claire (February 2024). "The Natural History and Treatment of Meningiomas: An Update" (in en). Seminars in Neurology 44 (1): 001–015. doi:10.1055/s-0043-1777352. ISSN 0271-8235. http://www.thieme-connect.de/DOI/DOI?10.1055/s-0043-1777352. 
  30. ↑ Almeida, Joao Paulo; Marigil-Sanchez, Miguel; Karekezi, Claire; Witterick, Ian; Gentili, Fred (2023). "Different Approaches in Skull Base Surgery Carry Risks for Different Types of Complications". in Turel, Keki E.; Chernov, Mikhail F.; Sarkar, Hrishikesh (in en). Complications in Neurosurgery. Acta Neurochirurgica Supplement. 130. Cham: Springer International Publishing. pp. 13–18. doi:10.1007/978-3-030-12887-6_2. ISBN 978-3-030-12887-6. https://link.springer.com/chapter/10.1007/978-3-030-12887-6_2. 
  31. ↑ Barthélemy, Ernest J.; Diouf, Sylviane A.; Silva, Ana Cristina Veiga; Abu-Bonsrah, Nancy; Souza, Isabella Assunção Santos de; Kanmounye, Ulrick Sidney; Gabriel, Phabinly; Sarpong, Kwadwo et al. (2023-02-06). "Historical determinants of neurosurgical inequities in Africa and the African diaspora: A review and analysis of coloniality" (in en). PLOS Global Public Health 3 (2). doi:10.1371/journal.pgph.0001550. ISSN 2767-3375. PMID 36962931. 
  32. ↑ Kanmounye, Ulrick Sidney; Karekezi, Claire; Nyalundja, Arsene Daniel; Awad, Ahmed K; Laeke, Tsegazeab; Balogun, James A (2022-10-03). "Adult brain tumors in Sub-Saharan Africa: A scoping review" (in en). Neuro-Oncology 24 (10): 1799–1806. doi:10.1093/neuonc/noac098. ISSN 1522-8517. PMID 35397473. PMC 9527516. https://academic.oup.com/neuro-oncology/article/24/10/1799/6566010. 
  33. ↑ Dada, Olaoluwa Ezekiel; Karekezi, Claire; Mbangtang, Celestin Bilong; Chellunga, Edwin Samwel; Mbaye, Thioub; Konan, Landry; Adeniran Bankole, Nourou Dine; Merci Kabulo, Katenga Dieu et al. (2021-07-01). "State of Neurosurgical Education in Africa: A Narrative Review". World Neurosurgery 151: 172–181. doi:10.1016/j.wneu.2021.05.086. ISSN 1878-8750. PMID 34058355. https://www.sciencedirect.com/science/article/pii/S1878875021007816. 
  34. ↑ Karekezi, Claire; Thango, Nqobile; Aliu-Ibrahim, Salamat Ahuoiza; Bechri, Hajar; You Broalet, Espérance Maman; Bougrine, Mouna; Cheserem, Jebet Beverly; Mbaye, Maguette et al. (March 2021). "History of African women in neurosurgery". Neurosurgical Focus 50 (3): E15. doi:10.3171/2020.12.FOCUS20905. ISSN 1092-0684. PMID 33789234. https://thejns.org/view/journals/neurosurg-focus/50/3/article-pE15.xml. 
  35. ↑ Karekezi, Claire; El Khamlichi, Abdeslam; El Ouahabi, Abdessamad; El Abbadi, Najia; Ahokpossi, Semevo Alidegnon; Ahanogbe, Kodjo Mensah Hobli; Berete, Ibrahima; Bouya, Soueilem Mohamed et al. (March 2020). "The impact of African-trained neurosurgeons on sub-Saharan Africa". Neurosurgical Focus 48 (3): E4. doi:10.3171/2019.12.FOCUS19853. ISSN 1092-0684. PMID 32114560. https://thejns.org/view/journals/neurosurg-focus/48/3/article-pE4.xml. 
  36. ↑ Marigil Sanchez, Miguel; Karekezi, Claire; Almeida, Joao Paulo; Kalyvas, Aristotelis; Castro, Vitor; Velasquez, Carlos; Gentili, Fred (2019-10-01). "Management of Giant Pituitary Adenomas: Role and Outcome of the Endoscopic Endonasal Surgical Approach". Neurosurgery Clinics of North America 30 (4): 433–444. doi:10.1016/j.nec.2019.05.004. ISSN 1042-3680. PMID 31471050. https://www.sciencedirect.com/science/article/pii/S1042368019300403. 
  37. ↑ Karekezi, Claire; El Khamlichi, Abdeslam (2019-06-01). "Takeoff of African Neurosurgery and the World Federation of Neurosurgical Societies Rabat Training Center Alumni". World Neurosurgery 126: 576–580. doi:10.1016/j.wneu.2019.03.141. ISSN 1878-8750. PMID 30910756. https://www.sciencedirect.com/science/article/pii/S1878875019308198. 



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